APPLICANT'S ABSTRACT: Alcohol use and intimate violence are significant public health problems for women that contribute to injury, poor health, mental illness, and disability. This project seeks to understand the role alcohol use may play in both health service utilization and victimization experiences by using baseline and follow-up interviews as well as event history data collection and analysis with intimate violence victims. Further, limited research indicates that the incidence of intimate violence across geographic areas may be similar, however, the qualitative experiences of intimate violence victims may differ across geographic areas. Within this context the overall aim of this study is to examine the effect of alcohol on the nature, extent, and co-occurrence of health service utilization over time among rural and urban women who have a protective order for intimate violence. This proposal is consistent with, and specifically addresses several research objectives in the NIAAA Health Services Research on Alcohol-Related Problems PA# PAS-98-037 including identifying the factors that impede or facilitate the receipt of care by different client populations; defining the characteristics of the treatment services received by those client populations; examining factors and interactions of factors that affect access to and utilization of alcohol treatment; and examining health service utilization patterns and factors that may affect health service utilization. The specific aims for this project are: (1) To describe similarities and differences in health service use patterns and victimization experiences among intimate violence victims with protective orders stratified by alcohol use-those who drink alcohol heavily (n=250), those who drink alcohol (n=250), and those who do not use alcohol (n=250) in rural and urban areas. (2) To examine the effect of alcohol use on the nature, extent, and co-occurrence of health service utilization and victimization patterns among rural and urban women who have a protective order. (3) To examine the association of social support, positive health practices, access to health care, perceptions of health care needs and beliefs, and stress with alcohol use and health service utilization among rural and urban women who have a protective order. And, (4) To examine changes in alcohol use, intimate violence victimization and health service utilization over a one year period from baseline to follow-up among rural and urban women who have protective orders.